护士参与外科抗菌药物管理策略的机会：一项定性研究。
Opportunities for nurse involvement in surgical antimicrobial stewardship strategies: A qualitative study.
机构信息
National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Level 5-Peter Doherty Research Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia; Faculty of Medicine, Dentistry and Health Sciences, Department of Infectious Diseases, University of Melbourne, Parkville, VIC 3010, Australia.
National Health and Medical Research Council Centre of Research Excellence: National Centre for Antimicrobial Stewardship (NCAS), Level 5-Peter Doherty Research Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia; Faculty of Medicine, Dentistry and Health Sciences, Department of Infectious Diseases, University of Melbourne, Parkville, VIC 3010, Australia.
出版信息
Int J Nurs Stud. 2022 Apr;128:104186. doi: 10.1016/j.ijnurstu.2022.104186. Epub 2022 Jan 29.
BACKGROUND
Multi-disciplinary antimicrobial stewardship teams are a common strategy employed to optimise antimicrobial prescribing. Nurses play a pivotal role in patient care and safety; however, their role and potential opportunities across surgical antimicrobial stewardship are not well-established. This study aims to highlight health professional perspectives of the nurse's role and relevant opportunities for nurses to engage in and lead surgical antimicrobial stewardship initiatives.
METHODS
An exploratory, multi-site, collective qualitative case study. Transcribed audio-recordings of focus groups with health professionals underwent thematic analysis, with mapping to established frameworks.
RESULTS
Four key themes were identified; surgical antimicrobial prophylaxis is not prioritised for quality improvement, but nurses perceive benefits from surgical antimicrobial prophylaxis education and training; professional hierarchy hinders nurse engagement and leadership in antimicrobial stewardship; nurses are consistently engaged with patient care throughout the surgical journey; and clarity of roles and accountability for surgical antimicrobial prophylaxis review and follow-up can bolster quality improvement initiatives.
DISCUSSION
Many opportunities exist for nurse engagement in surgical antimicrobial stewardship. Identification of barriers and enablers support theoretically informed strategies i.e., education and guideline accessibility; multidisciplinary collaborations; executive support for nursing capacity building and the standardisation of surgical antimicrobial prophylaxis workflow and documentation.
CONCLUSIONS
Nurses are critical to patient safety and to supporting antimicrobial stewardship, in the operating theatre, and throughout the patient's surgical journey. Applying theoretical frameworks to understand barriers and enablers to nurses' contribution to antimicrobial stewardship has given insights to inform interventions to support nurse engagement. : Tweetable abstract: Nurses are critical for patient safety. Many opportunities exist to support them as surgical antimicrobial stewards.
背景
多学科抗菌药物管理团队是优化抗菌药物处方的常用策略。护士在患者护理和安全中发挥着关键作用；然而，他们在外科抗菌药物管理中的角色和潜在机会尚未得到充分确立。本研究旨在强调卫生专业人员对护士角色的看法，以及护士参与和领导外科抗菌药物管理计划的相关机会。
方法
采用探索性、多地点、集体定性案例研究。对卫生专业人员焦点小组的转录音频记录进行主题分析，并与既定框架进行映射。
结果
确定了四个关键主题；外科抗菌药物预防措施并未优先考虑进行质量改进，但护士认为接受外科抗菌药物预防措施教育和培训有益；专业等级制度阻碍了护士参与和领导抗菌药物管理；护士在整个手术过程中始终参与患者护理；明确角色和对外科抗菌药物预防措施审查和随访的责任可以加强质量改进计划。
讨论
护士有很多机会参与外科抗菌药物管理。确定障碍和促进因素支持基于理论的策略，即教育和指南可及性；多学科合作；为护理能力建设提供行政支持以及手术抗菌药物预防措施工作流程和文件的标准化。
结论
护士对患者安全和支持抗菌药物管理至关重要，无论是在手术室还是在患者的整个手术过程中。应用理论框架来理解护士对抗菌药物管理贡献的障碍和促进因素，为支持护士参与提供了深入的见解。
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